Surgical Outcomes of Myopic Traction Maculopathy According to the International Photographic Classification for Myopic Maculopathy

Abstract

Purpose: To compare treatment results of myopic traction maculopathy according to the international photographic classification for myopic maculopathy. Methods: This was a retrospective, single-surgeon–based, observational case series of 35 consecutive eyes that underwent vitrectomy for myopic traction maculopathy. Eyes were classified into nonpathologic myopia (PM) (n = 15) and PM (n = 20) groups. Main outcome measures constituted best-corrected visual acuity (BCVA) and anatomical change. Results: The mean follow-up was 32.03 ± 6.85 months. Axial length correlated with myopic maculopathy category (rho = 0.6836, P < 0.001). In the total group, BCVA improved from 20/61 to 20/36 (P = 0.001). In the subgroup, BCVA improved from 20/41 to 20/22 in the non-PM group (P = 0.002), whereas from 20/82 to 20/52 in the PM group (P = 0.048). Postoperative BCVA of the PM group was inferior to that of the non-PM group (P = 0.002) and the PM group was more likely to have postoperative BCVA <20/30 (odds ratio, 17.3; 95% CI, 2.6–325.0; P = 0.012). Two cases of macular hole retinal detachment occurred after surgery in the PM group. Conclusion: Because there are limited benefits of vitrectomy in myopic traction maculopathy accompanied by PM, careful consideration would be necessary when determining surgery. Optical coherence tomography should not be used alone in determining vitrectomy because myopic traction maculopathy can also have PM defined mainly by fundus photographs.

Clinical Characteristics of Eyes With Different Grades of Myopic Traction Maculopathy

“…[7][8][9] Of them, myopic traction maculopathy (MTM) represented by macular schisis is considerably challenging to ophthalmologists because MTM is closely associated with severe vision loss and unsatisfactory therapeutic effects. [10][11][12][13][14] A previous study has categorized myopic macular retinoschisis according to its extent and location relative to the fovea. 15 Because of the diversity and complexity of MTM, a comprehensive classification has long been required.…”

Progression of Myopic Maculopathy in Patients With Myopic Traction Maculopathy After Vitrectomy

“…Earlier reports have suggested the possibility of a faster MM progression rate after vitrectomy for MTM. Lee et al 6 have reported the gradual progress of the extent and degree of chorioretinal atrophy in some path-ologic myopia cases after surgery. One case exhibited intercategory progression (Category 2-3).…”

“…5 Furthermore, suboptimal treatment results have been reported after vitrectomy for MTM, including the development of macular atrophy. 6,7 Lee et al 6 have pointed out that the determination of a surgical intervention for MTM based solely on OCT features could be misleading because it is difficult to decide whether visual impairment seen in MTM patients with MM is caused by MTM or MM. In addition, they reported cases of MM progression after vitrectomy in patients other than those with MTM.…”